| NPI | 1386157394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY KEATHLEY Billing Manager 682-312-7693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2019-05-06 |